HomeMy WebLinkAbout04-18-08
.-J
15056041147
REV-1500 EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes ~
PO BOX.280601 ~
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 8
File Number
0149
Date of Birth
170 16 6171
01 20 2008
01 04 2008
Decedent's Last Name
S utfix
Decedent's First Name
MI
STRUMLOK
STEPHEN
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
D 1. Original Return
4. Limited Estate
D
D
o
D
4a. Future Interest Compromise
(date of death after 12-12-82)
2. Supplemental Return
D
D
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
[!]
D
6. Decedent Died Testate
(Attach Copy of Will)
7 Decedent Maintained a Living Trust
. (Attach Copy of Trust)
8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received
10 Spousal Poverty Credit (date of death
. between 12-31-91 and i-1-95)
D
11. Ejection to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
EDMUND G. MYERS (717) 761 4540
Firm Name (If Applicable)
JOHNSON, DUFFIE, STEWART &
REGISTER OF WILLS USER!lL Y
o ,...,
~~- c:~:::,~
~
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First line of address
301 MARKET STREET
Second line of address
co
PO BOX 109
y
City or Post Office
LEMOYNE
State
PA
ZIP Code
17043
DA"t8:J:ILED
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Ul
CO
Correspondent's e-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE OR FILING RETURN DATE
Marilyn S McCoy
24 South 27th Street, Camp Hill, PA 17011
SIG RE OF PREPARER OTHER THAN REPRESENTATIVE
EDMUND G. MYERS
Lf/;;/o?,
301 MARKET STREET, Lemoyne, PA 17043
Side 1
L
15D56041147
15056D41147
.-JJ
---I
15056042148
REV-1500 EX
Decedent's Name: Stephen STRU MLOK
RECAPITULATION
1. Real Estate (Schedule A).......................................................................................... 1.
2. Stocks and Bonds (Schedule B)............................................................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages & Notes Receivable (Schedule D).......................................................... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)................ 5.
6. Jointly Owned Property (Schedule F) D Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested............. 7.
8. Total Gross Assets (total Lines 1-7)....................................................................... 8.
9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10.
11. Total Deductions (total Lines 9 & 10)......................................................................11.
12. Net Value of Estate (Line 8 minus Line 11).............................................................12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J)................................................. 13.
14. Net Value Subject to Tax (Line 12 minus Line 13)................................................. 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, of
transfers under Sec. 9116
(a)(1.2) X ~
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
0.00
15.
188,824.76
16.
0.00
17.
0.00
18.
19. Tax Due.................................................................................................................. J9.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15056042148
Decedent's Social Security Number
170 16 6171
155,884.60
51,466.64
207,351.24
5,997.47
12,529.01
18,526.48
188,824.76
188,824.76
0.00
8,497.11
0.00
0.00
8,497.11
D
15056042148
---I
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-08-0149
DECEDENT'S NAME
Stephen STRUMlOK
STREET ADDRESS
4833 E. Trindle Road Suite 574
CITY I STATE IZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
8,497.11
424.86
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
424.86
TotallnterestlPenalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5)
(5A)
(5B)
8,072.25
8,072.25
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.................................................................................0 0
b. retain the right to designate who shall use the property transferred or its income;....................................D 0
c. retain a reversionary interest; or...............................................................................................................0 0
d. receive the promise for life of either payments, benefits or care?............................................................. 0 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?....... ............ ........ ..................................................... ....................................0 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D [!J
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?............................................................................................... ....................0 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is three (3) percent [72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero
(0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemPB transfer to a surviving spouse from tax, and the statutory requirements
for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent,
except as noted in 72 P.S. 99116 1.2) [72 P.S. 99116 (a) (1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P .S. 99116 (a) (1.3)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-1508 EX+ (6-98)
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
STRUMLOK, Stephen
FILE NUMBER
21-08-0149
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 IRS Refund
VALUE AT DATE
OF DEATH
12.171.00
2 M&T Bank Certificate of Deposit Account No. 013003914968234
108.916.36
3 M& T Bank Checking Account No. 3740571389
34.797.24
TOTAL (Also enter on Line 5, Recapitulation)
155.884.60
(If more space is needed, additional pages of the same size)
Copyright (e) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
Rev-1509 EX+ (6-981 ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
STRUMLOK, Stephen
FILE NUMBER
21-08-0149
ESTATE OF
If an asset was made joint within one year of the decedenfs date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME
A. Marilyn S McCoy
ADDRESS
RELATIONSHIP TO DECEDENT
24 South 27th Street
17011,PA
Daughter
B.
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
LETTER DATE
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAl INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST
JOINTLY-HELD REAL ESTATE.
1 1/30/1985 M& T Bank Savings Account No. 102.933.27 50.000% 51.466.64
015004200021381
TOTAL (Also enter on line 6, Recapitulation) 51.466.64
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule F (Rev. 6-98)
REV-1151 EX+ (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
STRUMLOK, Stephen
FILE NUMBER
21-08-0149
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 478.44
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees JOHNSON, DUFFIE, STEWART & WEIDNER 4,600.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 352.00
5. Accountant's Fees
6. Tax Return Preparer's Fees 150.00
7. Other Administrative Costs 417.03
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 5,997.47
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502IoX+ (6-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
STRUMLOK, Stephen
FILE NUMBER
21-08-0149
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Hoffman Roth Funeral Home
478.44
Subtotal
478.44
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
STRUMLOK, Stephen
FILE NUMBER
21-08-0149
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland County Regsiter of Wills Office
30.00
2
Reserves: Final Costs for Administration of Estate
150.00
3
The Cumberland Law Journal - Notice of Estate Administration
75.00
4
The Patriot News Company - Notice of Estate Administration
162.03
Subtotal
417.03
Copyright (c) 2002 form software only The Lackner Group. Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
STRUMLOK, Stephen
FILE NUMBER
21-08-0149
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Alert Pharmacy
VALUE AT DATE
OF DEATH
307.76
2 Megan Evans, CPA
200.00
3 Messiah Village
11.906.25
4 Pa Department of Revenue
115.00
TOTAL (Also enter on Line 10, Recapitulation)
12,529.01
(If more space is needed, additiDnal pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 EX+ (9-00)
.
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
STRUMLOK, Stephen
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
aistributions, and transfers
under Sec. 9116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(sl
FILE NUMBER
21-08-0149
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Marilyn S McCoy
24 South 27th Street
Camp Hill, PA 17011
Stephen R Strumlok
916 Nottingham Road
Jamesville, NY 13078
Daughter
1/3rd of Estate
97,252.68
Son
1/3rd of Estate
45,786.04
Nancy Vardaro
1260 Stevens Street
Manheim, PA 17545
Daughter
1/3rd of Estate
45,786.04
Total 188,824.76
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
EXHIBIT A
EXHIBIT B
:330125
ESTATE OF STEPHEN STRUMLOK
SCHEDULE OF EXHIBITS
Last Will & Testament for Stephen Strum/ok dated May 1 ih, 1995.
Date of Death Letter from M&T Bank
.
.
-.-.........~
1East Bill &ttb m~!ttcttUtttt
OF
STEPHEN STRUMLOK
I, STEPHEN STRUMLOK, of Silver Springs Township, Cumberland County,
Pennsylvania, do hereby make, publish and declare this to be my last Will and
Testament, hereby revoking all former Wills by me at any time heretofore made.
FIRST:
I direct the payment of my just debts and funeral expenses as soon
after my death as will be convenient to my Executrix hereinafter named.
SECOND: I give, devise and bequeath all of my property, whether real, personal
lOr mixed, and wheresoever situate at the time of my death in equal shares, share and
share alike, to my children, MARILYN S. McCOY, STEPHEN R. STRUMLOK and
NANCY C. VARDARO, or to the issue of any deceased child, per stirpes.
THIRD:
I nominate, constitute and appoint my daughter, MARILYN S.
McCOY, to be the Executrix of this my Last Will and Testament. Should my daughter,
MARILYN S. McCOY, fail to survive me, I appoint my daughter, NANCY C. VARDARO,
-4-<"
t'
initials <
~~tm~"....,... "
to act as such Executrix in her place and stead. No Executrix shall be required to file a
bond.
IN WITNESS WHEREOF, I hereunto set my hand and seal this
176
day of /rJ J1l#
,1995.
/~IuJl LlJJ;~r4d7[
I Stephen StrtJmlok
SIGNED, SEALED, PUBLISHED and
DECLARED in the presence of:
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COMMONWEALTH OF PENNSYLVANIA
: 55.
COUNTY OF CUMBERLAND
I, STEPHEN STRUMLOK, Testator, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will; that I signed it
willingly; and that I signed it as my free and voluntary act for the purposes therein
expressed.
Sworn or affirmed to and acknowledged before me, by STEPHEN STRUMLOK, Testator,
this / 7 rf- day of 1}1--,e;; , 1995.
/?Jjq;h'h /{7~p'4?7
( , Steph(n s~rumlok, Testator
/.--;..
:7&i.e~J
NOTARIAL SEAL II
TERESA J. BURKHOLDER, Notary Public I
Carlisle, Cumberland County, Pa.
My Commission Expires Feb. 12, 1996 -1
3
_ ',,1;'~r'.,7._.._~.~,\"~"', ','_-,_"-""';_.""_" 07-" .,..'C'l-'_'>:"'~"'~"'''"' ,'.,.. .'";_0 .,,,T... ,....--,
COMMONWEALTH OF PENNSYLVANIA
: SSe
COUNTY OF CUMBERLAND
We, JAMES D. FLOWER and CAROL J. LINDSAY , the
witnesses whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were present and saw Testator,
STEPHEN STRUMLOK, sign and execute the instrument as his Last Will; that he signed
willingly and that he executed it as his free and voluntary act for the purposes therein
expressed; that each of us in the sight of the Testator signed the Will as witnesses; and
that to the best of our knowledge the Testator was at that time 18 or more years of age,
of sound mind and under no constraint or undue influence.
and
Sworn or affirmed to and subscribed to before me by JAMES D. FLOWER
(,~R()T..T T,TNnS~Y , witnesses, this /;;1t't day of ''-;"tY/aLr--'', 1995.
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NOTARIAL SEAL
TERESA J. BURKHOLDER, Notary Public
Carlisle, Cumbertand County, Pa.
4 My Commission Expires Feb. 12,1996
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fmM&rBank
499 Mitchell Road, MiIIsboro, DE ]9966 Mail Code DE-MB-]2
Phone (888) 502-4349
Fax (302) 934-2955
March 5, 2008
Law Offices
Johnson Duffie
301 Market Street
POBox 109
Lemoyne, Pennsylvania 17043-0109
Re: Estate of Stephen Strumlok
Social Security: 170-16-6171 changed to # 26-6230652
Date of Death: Januarv 20, 2008
Dear Sir or Madam:
Per your inquiry dated February 27, 2008, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1.
Type of Account
Checking Account
Account Number
3740571389
Ownership (Names oj)
Stephen Strumlok *
Opening Date
10/08/98
Balance on Date of Death
$34,796.20
Accrued Interest
$
1.04
Total
$34,797.24
2.
Type of Account
Savings Account
Account Number
015004200021381
Ownership (Names oj)
Marilyn S McCoy *
Stephen Strumlok *
Opening Date
01/30/85 Closed 02/12/08
Balance on Date of Death
$102,725.84
Accrued Interest
$
207.43
Total
$102,933.27
3. Type of Account Certificate of Deposit
Account Number 031003914968234
Ownership (Names oj) Stephen Strumlok *
Opening Date 12/19/05
Balance on Date of Death $104,695.92
Accrued Interest $ 4,220.44
__._____________...__n__u ..__ _.___._..__.n.... __"'n_n__ n" ,____~".__,___..._._
Total $108,916.36
Please be advised, there was no safe deposit box found for the above decedent.
* If upon reviewing the information above, you believe there are additional accounts not referenced, please provide
us with an account number and/or name of any possible joint account holder. For any additional information on
the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the
High Street Carlisle Office # 717-240-4536.
Sincerely,
~~vey~~"-Y
Nancy Clagett
Records Management
JERRY R. DCFFIE
RICHARD W. STEWART
C. ROY WEIDNER. IR
EDMU"W G. MYERS
DAVID W DELUCE
JOHN A. STATLER
JEFFERSON J SHIPMAN
JEFFREY B. RETTIG
KEVIN E. OSBORNE
RALPH H. WRIGHT.IR
MARK C. DCFFIE
JOHN R. ~1t\OSKY
MICHAEL J. CASSIDY
LAW OFFICES
JOHNSON
DUFFIE
MELISSA PEEL GREEVl
ROBERT M. WALKEH
WADE D. MAt\LE\
ELIZABETH D S\OVER
KEl.LY L. BO\A\NO
OF COUNSEL
HORACE A. IOHNSOC;
FLEE SHIPMAC;
( 19h'l-2111l6i
April 17, 2008
co
Register of Wills Office
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
-'\'")
::::t:
1""-'
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co
RE:
Estate of Stephen Strumlok
Date of Death: January 20,2008
Our File No. 013664-1
Dear Register:
Enclosed for filing please find the following documents for the above referenced decedent:
1. 2 Original PA Inheritance Tax Returns with tax due in the amount of $8,072.25. This payment also
reflects the 3 month early prepayment of inheritance tax. Check No. 102 is attached to the Return
2. Inventory
3. Two copies of Pages 1 of the Pa Inheritance tax return, which we ask that you time-stamp and return to
us in the enclosed envelope.
4. 1 copy of the Inventory, which we ask that you time-stamp and return to us in the enclosed envelope.
5. Check No. 103 is attached to this correspondence in the amount of $30.00 representing the filing
fee for the Inheritance Tax Return ($15.00) and Inventory ($15.00).
Should you have any questions, please do not hesitate to contact our office. Thank you for your attention to this
matter.
Ene.
cc: Marilyn McCoy, Executrix
:329543
3\\)
301 MARKET STREET PO. BOX 109 LEMOYNE. PEN:-iSYLVANIA 17043-0109
WWW.JDSW.COM 717.761.4540 FAX: 717.761.3015 MAIL@JDSWCOM
JOHNSON, DUFFIE, STEWART & WEIDNER, P.C.